FORM 1023-EZ for AFFORDABLE SAFE HOUSING

Field Data
EIN 82-3321804
Case Number EO-2019029-000351
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name AFFORDABLE SAFE HOUSING
Organization’s Mailing Address 3075 NORMANDY RD
City SPRINGFIELD
State IL
ZIP 62703
Accounting period End 11
Primary contact name MARCIA DEAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARCIA DEAN
PRESIDENT
400 E MADISON ST APT 312
SPRINGFIELD IL 62701

Officer/Director/Trustee Two

CORY BETTS
VICE- PRESIDENT
915 S 4TH APT 1
SPRINGFIELD IL 62701

Officer/Director/Trustee Three

ABAYOMI ODUIBRO
TRESURER
2513 MANDAN
SPRINGFIELD IL 62702

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/6/17
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code L20 - Housing Development, Construction, Management
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee No
Donation of funds No
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance No
One Third Support Public Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name MARCIA DEAN
Signature Title PRESIDENT
Signature Date 12/17/18

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